tbuckley/cabot-search huggingface dataset:
Current Comment
Journal: JAMA (2023)

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Is Personalized Antihypertensive Drug Selection Feasible?
Authors: Robert M. Carey
Journal: JAMA (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Antitumor Efficacy of Dual Blockade with Encorafenib + Cetuximab in Combination with Chemotherapy in Human <i>BRAF</i>V600E-Mutant Colorectal Cancer
Authors: Stefania Napolitano, Melanie Woods, Hey Min Lee, Vincenzo De Falco, Giulia Martini, Carminia Maria Della Corte, Erika Martinelli, Vincenzo Famiglietti, Davide Ciardiello, Amanda Anderson, Natalie Wall Fowlkes, Oscar Eduardo Villareal, Alexey Sorokin, Preeti Kanikarla, Olu Coker, Van Morris, Lucia Altucci, Josep Tabernero, Teresa Troiani, Fortunato Ciardiello, Scott Kopetz
Journal: Clinical Cancer Research (2023)

Abstract Purpose: Encorafenib + cetuximab (E+C) is an effective therapeutic option in chemorefractory BRAFV600E metastatic colorectal cancer (mCRC). However, there is a need to improve the efficacy of this molecular-targeted therapy and evaluate regimens suitable for untreated BRAFV600E in patients with mCRC. Experimental Design: We performed a series of in vivo studies using BRAFV600E mCRC tumor xenografts. Mice were randomized to receive 5-fluoruracil (5-FU), irinotecan, or oxaliplatin regimens (FOLFIRI or FOLFOX), (E+C) or the combination. Patients received long-term treatment until disease progression, with deescalation strategies used to mimic maintenance therapy. Transcriptomic changes after progression on cytotoxic chemotherapy or targeted therapy were assessed. Results: Antitumor activity of either FOLFIRI or E+C was better as first-line treatment as compared with second-line, with partial cross-resistance seen between a cytotoxic regimen and targeted therapy with an average 62% loss of efficacy for FOLFIRI after E+C and a 45% loss of efficacy of E+C after FOLFIRI (P &amp;lt; 0.001 for both). FOLFIRI-treated models had upregulation of epithelial–mesenchymal transition (EMT) and MAPK pathway activation, where E+C treated models had suppressed MAPK signaling. In contrast, with chemotherapy with E+C, EMT and MAPK signaling remained suppressed. FOLFOX or FOLFIRI, each in combination with E+C, were the most active first-line treatments as compared with E+C or to chemotherapy alone. Furthermore, FOLFOX in combination with E+C as first-line induction therapy, followed by E+C ± 5-FU as maintenance therapy, was the most effective strategy for long-term disease control. Conclusions: These results support the combination of cytotoxic chemotherapy and molecular-targeted therapy as a promising therapeutic approach in the first-line treatment of BRAFV600E mCRC.
Over-the-counter Hearing Aids—Reply
Authors: Debara L. Tucci, Robert M. Califf
Journal: JAMA (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Preconception paternal ethanol exposures induce alcohol-related craniofacial growth deficiencies in fetal offspring
Authors: Kara N. Thomas, Nimisha Srikanth, Sanat S. Bhadsavle, Kelly R. Thomas, Katherine N. Zimmel, Alison Basel, Alexis N. Roach, Nicole A. Mehta, Yudhishtar S. Bedi, Michael C. Golding
Journal: Journal of Clinical Investigation (2023)

Preconception paternal ethanol exposures
Endothelin-1, Outcomes in Patients With Heart Failure and Reduced Ejection Fraction, and Effects of Dapagliflozin: Findings From DAPA-HF
Authors: Su Ern Yeoh, Kieran F. Docherty, Ross T. Campbell, Pardeep S. Jhund, Ann Hammarstedt, Hiddo J.L. Heerspink, Petr Jarolim, Lars Køber, Mikhail N. Kosiborod, Felipe A. Martinez, Piotr Ponikowski, Scott D. Solomon, Mikaela Sjöstrand, Olof Bengtsson, Peter J. Greasley, Naveed Sattar, Paul Welsh, Marc S. Sabatine, David A. Morrow, John J.V. McMurray
Journal: Circulation (2023)

ET-1 (endothelin-1) is implicated in the pathophysiology of heart failure and renal disease. Its prognostic importance and relationship with kidney function in patients with heart failure with reduced ejection fraction receiving contemporary treatment are uncertain. We investigated these and the efficacy of dapagliflozin according to ET-1 level in the DAPA-HF trial (Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure).
Trainee Physician Milestone Ratings and Patient Complaints in Early Posttraining Practice
Authors: Misop Han, Stanley J. Hamstra, Sean O. Hogan, Eric Holmboe, Kelly Harris, Eric Wallen, Gerald Hickson, Kyla P. Terhune, Donald W. Brady, Bruce Trock, Kenji Yamazaki, Jessica L. Bienstock, Henry J. Domenico, William O. Cooper
Journal: JAMA Network Open (2023)

Importance Evaluation of trainees in graduate medical education training programs using Milestones has been in place since 2013. It is not known whether trainees who have lower ratings during the last year of training go on to have concerns related to interactions with patients in posttraining practice. Objective To investigate the association between resident Milestone ratings and posttraining patient complaints. Design, Setting, and Participants This retrospective cohort study included physicians who completed Accreditation Council for Graduate Medical Education (ACGME)–accredited programs between July 1, 2015, and June 30, 2019, and worked at a site that participated in the national Patient Advocacy Reporting System (PARS) program for at least 1 year. Milestone ratings from ACGME training programs and patient complaint data from PARS were collected. Data analysis was conducted from March 2022 to February 2023. Exposures Lowest professionalism (P) and interpersonal and communication skills (ICS) Milestones ratings 6 months prior to the end of training. Main Outcomes and Measures PARS year 1 index scores, based on recency and severity of complaints. Results The cohort included 9340 physicians with median (IQR) age of 33 (31-35) years; 4516 (48.4%) were women physicians. Overall, 7001 (75.0%) had a PARS year 1 index score of 0, 2023 (21.7%) had a score of 1 to 20 (moderate), and 316 (3.4%) had a score of 21 or greater (high). Among physicians in the lowest Milestones group, 34 of 716 (4.7%) had high PARS year 1 index scores, while 105 of 3617 (2.9%) with Milestone ratings of 4.0 (proficient), had high PARS year 1 index scores. In a multivariable ordinal regression model, physicians in the 2 lowest Milestones rating groups (0-2.5 and 3.0-3.5) were statistically significantly more likely to have higher PARS year 1 index scores than the reference group with Milestones ratings of 4.0 (0-2.5 group: odds ratio, 1.2 [95% CI, 1.0-1.5]; 3.0-3.5 group: odds ratio, 1.2 [95% CI, 1.1-1.3]). Conclusions and Relevance In this study, trainees with low Milestone ratings in P and ICS near the end of residency were at increased risk for patient complaints in their early posttraining independent physician practice. Trainees with lower Milestone ratings in P and ICS may need more support during graduate medical education training or in the early part of their posttraining practice career.
Competency-Based Medical Education—A Journey or a Destination?
Authors: Atul Grover, Lisa Doyle Howley
Journal: JAMA Network Open (2023)

Misop Han, MD, MS; Stanley J. Hamstra, PhD; Sean O. Hogan, PhD; Eric Holmboe, MD; Kelly Harris, MD; Eric Wallen, MD; Gerald Hickson, MD; Kyla P. Terhune, MD, MBA; Donald W. Brady, MD; Bruce Trock, PhD; Kenji Yamazaki, PhD; Jessica L. Bienstock, MD, MPH; Henry J. Domenico, MS; William O. Cooper, MD, MPH
Association Between Rheumatoid Arthritis and Osteoporosis in Japanese Populations: A Mendelian Randomization Study
Authors: Yunyang Deng, Martin Chi Sang Wong
Journal: Arthritis & Rheumatology (2023)

The positive association between rheumatoid arthritis (RA) and osteoporosis has been reported in previous observational studies, but the causal relationship remains unclear. This study was undertaken to investigate whether RA was causally associated with osteoporosis in Japanese populations using Mendelian randomization (MR) analyses.Publicly available summarized data from genome-wide association studies (GWAS) on RA (4,199 cases and 208,254 controls) and osteoporosis (7,788 cases and 204,665 controls) were obtained from BioBank Japan. Eleven RA-related single-nucleotide polymorphisms (P < 5×10-8 ) were selected as instrumental variables. We used the inverse variance-weighted method as the primary method to calculate the odds ratios (ORs) and 95% confidence intervals (95% CIs). We also used the MR-Egger's method, weighted median, and weighted mode to determine the robustness of the main results. To partially test the horizontal pleiotropy, we used the MR-Egger's intercept test and the Mendelian randomization pleiotropy residual sum and outlier (MRPRESSO) test.Using the inverse variance-weighted method, we showed that genetically predicted RA was positively associated with osteoporosis (OR 1.10, 95% CI 1.06-1.14, P < 0.001). The positive association was robust when we tested the results using the MR-Egger's method (OR 1.09, 95% CI 1.03-1.16, P = 0.023), weighted median (OR 1.09, 95% CI 1.04-1.15, P < 0.001), and weighted mode (OR 1.08, 95% CI 1.03-1.13, P = 0.012). Horizontal pleiotropy was not detected (P = 0.737) by the MR-Egger's intercept test or the MRPRESSO test.Our results show a potential causal association between genetically predicted RA and osteoporosis. The finding was consistent when we used different MR methods and the sensitivity analysis. Further MR studies are needed when GWAS with more details of RA and osteoporosis performed in other East Asian/Japanese populations are available.
Sublingual Buprenorphine-Naloxone Exposure and Dental Disease—Reply
Authors: Mahyar Etminan, Ramin Rezaeianzadeh
Journal: JAMA (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
“it was”: Saying More With Less
Authors: Rafael Campo
Journal: JAMA (2023)

It wasn't her face.It wasn't her age, or the story, or the blood.It wasn't even the hole from the bullet where it had blown off her ear.It was the nurse, tucking her in, smoothing her blankets, arranging her hair.It was the sound of her mother's sharp wail, as we walked away, as she collapsed on the floor.
Clinicians’ Perspectives on Proactive Patient Safety Behaviors in the Perioperative Environment
Authors: Caoimhe Duffy, Neil Menon, David Horak, Geoffrey D. Bass, Ruchika Talwar, Cara Lorenzi, Christina Taing Vo, Chienhui Chiang, Justin B. Ziemba
Journal: JAMA Network Open (2023)

The perioperative environment is hazardous, but patients remain safe with a successful outcome during their care due to staff adaptability and resiliency. The behaviors that support this adaptability and resilience have yet to be defined or analyzed. One Safe Act (OSA), a tool and activity developed to capture self-reported proactive safety behaviors that staff use in their daily practice to promote individual and team-based safe patient care, may allow for improved definition and analysis of these behaviors.To thematically analyze staff behaviors using OSA to understand what may serve as the basis for proactive safety in the perioperative environment.This qualitative thematic analysis included a convenience sample of perioperative staff at a single-center, tertiary care academic medical center who participated in an OSA activity during a 6-month period in 2021. All perioperative staff were eligible for inclusion. A combined deductive approach, based on a human factor analysis and classification framework, as well as an inductive approach was used to develop themes and analyze the self-reported staff safety behaviors.Those selected to participate were asked to join an OSA activity, which was conducted in-person by a facilitator. Participants were to self-reflect about their OSA (proactive safety behavior) and record their experience as free text in an online survey tool.The primary outcome was the development and application of a set of themes to describe proactive safety behaviors in the perioperative environment.A total of 140 participants (33 nurses [23.6%] and 18 trainee physicians [12.9%]), which represented 21.3% of the 657 total perioperative department full-time staff, described 147 behaviors. A total of 8 non-mutually exclusive themes emerged with the following categories and frequency of behaviors: (1) routine-based adaptations (46 responses [31%]); (2) resource availability and assessment adaptations (31 responses [21%]); (3) communication and coordination adaptation (23 responses [16%]); (4) environmental ergonomics adaptation (17 responses [12%]); (5) situational awareness adaptation (12 responses [8%]); (6) personal or team readiness adaptation (8 responses [5%]); (7) education adaptation (5 responses [3%]); and (8) social awareness adaptation (5 responses [3%]).The OSA activity elicited and captured proactive safety behaviors performed by staff. A set of behavioral themes were identified that may serve as the basis for individual practices of resilience and adaptability that promote patient safety.
Sublingual Buprenorphine-Naloxone Exposure and Dental Disease
Authors: Thomas D. Brothers, Dan Lewer, Matthew Bonn
Journal: JAMA (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Use of Machine Learning to Differentiate Children With Kawasaki Disease From Other Febrile Children in a Pediatric Emergency Department
Authors: Chih-Min Tsai, Chun-Hung Richard Lin, Ho-Chang Kuo, Fu-Jen Cheng, Hong-Ren Yu, Tsung-Chi Hung, Chuan-Sheng Hung, Chih-Ming Huang, Yu-Cheng Chu, Ying-Hsien Huang
Journal: JAMA Network Open (2023)

Early awareness of Kawasaki disease (KD) helps physicians administer appropriate therapy to prevent acquired heart disease in children. However, diagnosing KD is challenging and relies largely on subjective diagnosis criteria.To develop a prediction model using machine learning with objective parameters to differentiate children with KD from other febrile children.This diagnostic study included 74 641 febrile children younger than 5 years who were recruited from 4 hospitals, including 2 medical centers and 2 regional hospitals, between January 1, 2010, and December 31, 2019. Statistical analysis was performed from October 2021 to February 2023.Demographic data and laboratory values from electronic medical records, including complete blood cell count with differential, urinalysis, and biochemistry, were collected as possible parameters. The primary outcome was whether the febrile children fulfilled the diagnostic criteria of KD. The supervised eXtreme Gradient Boosting (XGBoost) machine learning method was applied to establish a prediction model. The confusion matrix and likelihood ratio were used to evaluate the performance of the prediction model.This study included a total of 1142 patients with KD (mean [SD] age, 1.1 [0.8] years; 687 male patients [60.2%]) and 73 499 febrile children (mean [SD] age, 1.6 [1.4] years; 41 465 male patients [56.4%]) comprising the control group. The KD group was predominantly male (odds ratio, 1.79; 95% CI, 1.55-2.06) with younger age (mean difference, -0.6 years [95% CI, -0.6 to -0.5 years]) compared with the control group. The prediction model's best performance in the testing set was able to achieve 92.5% sensitivity, 97.3% specificity, 34.5% positive predictive value, 99.9% negative predictive value, and a positive likelihood ratio of 34.0, which indicates outstanding performance. The area under the receiver operating characteristic curve of the prediction model was 0.980 (95% CI, 0.974-0.987).This diagnostic study suggests that results of objective laboratory tests had the potential to be predictors of KD. Furthermore, these findings suggested that machine learning with XGBoost can help physicians differentiate children with KD from other febrile children in pediatric emergency departments with excellent sensitivity, specificity, and accuracy.
Increased Nerve Density Adversely Affects Outcome in Oral Cancer
Authors: Cindy Perez-Pacheco, Ligia B. Schmitd, Allison Furgal, Emily L. Bellile, Min Liu, Aya Fattah, Laura Gonzalez-Maldonado, Shelby P. Unsworth, Sunny Y. Wong, Laura S. Rozek, Arvind Rao, Gregory T. Wolf, Jeremy M.G. Taylor, Keith Casper, Michelle Mierzwa, Nisha J. D'Silva
Journal: Clinical Cancer Research (2023)

Abstract Purpose: Perineural invasion (PNI) in oral cavity squamous cell carcinoma (OSCC) is associated with poor survival. Because of the risk of recurrence, patients with PNI receive additional therapies after surgical resection. Mechanistic studies have shown that nerves in the tumor microenvironment promote aggressive tumor growth. Therefore, in this study, we evaluated whether nerve density (ND) influences tumor growth and patient survival. Moreover, we assessed the reliability of artificial intelligence (AI) in evaluating ND. Experimental Design: To investigate whether increased ND in OSCC influences patient outcome, we performed survival analyses. Tissue sections of OSCC from 142 patients were stained with hematoxylin and eosin and IHC stains to detect nerves and tumor. ND within the tumor bulk and in the adjacent 2 mm was quantified; normalized ND (NND; bulk ND/adjacent ND) was calculated. The impact of ND on tumor growth was evaluated in chick chorioallantoic-dorsal root ganglia (CAM-DRG) and murine surgical denervation models. Cancer cells were grafted and tumor size quantified. Automated nerve detection, applying the Halo AI platform, was compared with manual assessment. Results: Disease-specific survival decreased with higher intratumoral ND and NND in tongue SCC. Moreover, NND was associated with worst pattern-of-invasion and PNI. Increasing the number of DRG, in the CAM-DRG model, increased tumor size. Reduction of ND by denervation in a murine model decreased tumor growth. Automated and manual detection of nerves showed high concordance, with an F1 score of 0.977. Conclusions: High ND enhances tumor growth, and NND is an important prognostic factor that could influence treatment selection for aggressive OSCC. See related commentary by Hondermarck and Jiang, p. 2342